Physical Therapy ICU Considerations

Question 1

ICU patients

Answer 1

Patientswithacuteexacerbationof respiratory failure

Question 2

HR normal

Answer 2

60-100

Question 3

RR normal

Answer 3

12-20

Question 4

CVP normal

Answer 4

0-8 mm Hg

Question 5

ICU before treatment

Answer 5

• Review medical chart prior to treatment to be alert to any recent changes in status
• Check with nursing prior to treatment

Question 6

ICU during treatment

Answer 6

Check vitals on monitor, record serially throughout intervention

Question 7

ICU after treatment

Answer 7

Communicate with the rest of the team

Question 8

someone on a ventilator - can they get PT

Answer 8

yes

Question 9

why is PT good for someone on a ventilator

Answer 9

prevent the negative things of
* Immobility
* Respiratory muscle weakness

Cardiovascular
* Decreased ability to perform aerobic work
* Orthostatic hypotension-decreased circulating blood volume,
decreased tone of vasculature
* DVT and PE

Question 10

ICU impacts on MSK system

Answer 10

Contractures
atrophy
decreased strength

Question 11

ICU psychosis

Answer 11

delirium from environmental and medical disturbances

Question 12

Splinting needs

Answer 12

foot drop, positioning

Question 13

caution with what level of FiO2

Answer 13

caution with FI02 > 60

Question 14

can a pt on particle ventilation be able to participate in breathing exercises

Answer 14

yes

Question 15

oxygen demand and PT timing

Answer 15

Time physical therapy intervention so that oxygen demand is not increased by PT intervention at a time when oxygen demand is elevated from weaning process

Question 16

what is the John-Hopkins Highest Level of Mobility (JH-HLM)

Answer 16

common lang tool

performance measure of the patient’s highest level of mobility achieved

Question 17

proning and alveolar​ area

Answer 17

improve v/q ratio by allowing alveoli improved available surface area and inflation

Question 18

at what time is proning beneficial​

Answer 18

ATLEAST 16 hours out of 24 in prone

Question 19

peep that is contraindicated for PT

Answer 19

greater than 10 cm H2O

Question 20

contraindicated for PT - O2 level

Answer 20

Consistent O2 Saturations less than 92%

Question 21

desaturations

Answer 21

Drops in blood oxygen level

Question 22

contraindicated for PT - position chnages

Answer 22

desaturations with positional changes during nursing care

Question 23

contraindicated for PT - ph level

Answer 23

Severe Acidosis with pH less than 7.30

Question 24

yellow sign

Answer 24

Potential risk and consequences of an adverse event are higher than green but may be outweighed by the potential benefits of mobilization.

The precautions or consideration should be given to doing so gradually and cautiously.

Question 25

red sign

Answer 25

Significant potential risk or consequences of an adverse event

Active mobilization should not occur unless specifically authorized by the treating intensive care specialist in consultation with the senior physical therapist and senior nursing staff.